The pump versus the pancreas

M has returned from diabetes camp this year to tell me that she would like to wear a pump. An insulin pump is one of those somewhat misunderstood inventions that people ask me about.

"Can't she just get a pump?"

Sure, she can. But it doesn't do what you think it does. It is NOT and artificial pancreas.

In a normal human being, this thing called the pancreas does this really important job. It's hard for most of the American public to know this, because nobody outside of the medical world seems to know what it does. On a recent TV show, I heard the line, "So what does a pancreas do besides get cancer?"

Good question. In very simple terms, it breaks down sugar into small enough bits that your body can actually use them. When your pancreas dies (yes, dies, not "stops functioning properly", because that's just sugar coating it - pardon the pun), it can no longer do the very important job of making a large portion of your food useful. That is why diabetics pee so much. They are peeing out their food. Then they are thirsty because they are peeing so much. It is also why they get skinny really fast. They are peeing out all of their food.

In other words they are starving to death, even though they are eating. Without the necessary nutrients, the body starts to eat itself, starting with very important organs, like the kidneys.

                     The pancreas: The ugly little thing you didn't even know was there.

So, anyhow, the pancreas is very smart. It senses how much sugar you have ingested, and releases the appropriate amount of insulin to break the food into usable bits. Not too much, not too little. It monitors the blood glucose level, and releases the appropriate amount of insulin. See how I wrote that twice? It's important.

A pump releases insulin. That's what it does. It does not monitor blood glucose. It needs to be told what a person's bg levels are, and mechanically dispenses what it is told to dispense. My concern: in theory, a person's blood sugar could be low, and the pump will continue to pump insulin into the body. Now the low bg become even lower and possibly life threatening.

Now, don't get me wrong. I am grateful that my daughter was born in a time where:

1) She won't automatically die from diabetes.

2) Insulin is easily measured and dispensed.

3) Bg levels can be tested pretty accurately by blood sticks rather than by using urine, which tells you what your bg WAS a few hours ago.

4) I don't have to boil syringes.

5) Needles are pretty darn tiny.

6) She has options to treat her diabetes. Including the pump.

I just have a lot of questions. And I don't think that's wrong.